How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $109.65 Median $2,884.03 Typical High $10,964.78 | Facility | None | $109.65 | $2,884.03 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $95.50 Typical High $158.49 | Professional | None | $56.23 | $95.50 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $109.65 | Professional | None | $77.62 | $91.20 | $109.65 |
AvMed Setting Facility Modifier None Typical Low $63.10 Median $2,137.96 Typical High $11,748.98 | Facility | None | $63.10 | $2,137.96 | $11,748.98 |
AvMed Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $141.25 | Professional | None | $53.70 | $85.11 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $70.79 Typical High $138.04 | Facility | None | $52.48 | $70.79 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $81.28 Typical High $177.83 | Professional | None | $41.69 | $81.28 | $177.83 |
Florida Blue Setting Facility Modifier None Typical Low $60.26 Median $131.83 Typical High $3,981.07 | Facility | None | $60.26 | $131.83 | $3,981.07 |
Florida Blue Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $128.82 | Professional | None | $70.79 | $75.86 | $128.82 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $208.93 | Professional | None | $74.13 | $107.15 | $208.93 |
United Setting Facility Modifier None Typical Low $81.28 Median $302.00 Typical High $2,818.38 | Facility | None | $81.28 | $302.00 | $2,818.38 |
United Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $194.98 | Professional | None | $50.12 | $93.33 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $38.02 Median $77.62 Typical High $77.62 | Professional | None | $38.02 | $77.62 | $77.62 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $41.69 Typical High $54.95 | Professional | 52 · Reduced service | $28.18 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.60 Typical High $21.88 | Professional | 53 · Discontinued | $11.48 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $61.66 Typical High $83.18 | Professional | 54 · Surgery only | $42.66 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.30 Typical High $16.60 | Professional | 55 · Aftercare only | $8.51 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $10.96 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 59 · Distinct service | $91.20 | $91.20 | $91.20 |
Where Florida sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Florida· 44th of 51
$100
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.